CPT code 27070 is for the partial removal of a hip bone, a procedure often used to treat various hip conditions.
CPT code 27070 is used to describe a surgical procedure involving the partial removal of the hip bone, specifically the femur or acetabulum. This procedure may be performed to alleviate pain, improve mobility, or address conditions such as fractures or tumors affecting the hip joint. It is typically indicated for patients with significant hip issues that cannot be resolved through conservative treatments.
When billing for the CPT code 27070, which pertains to the partial removal of the hip bone, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 50 - Bilateral Procedure: This modifier is used when the procedure is performed on both sides of the body.
2. Modifier 51 - Multiple Procedures: This modifier indicates that multiple procedures were performed during the same session.
3. Modifier 52 - Reduced Services: This modifier is applicable when the service provided is less than what is typically required for the procedure.
4. Modifier 53 - Discontinued Procedure: This modifier is used when a procedure is terminated due to extenuating circumstances or the patient's condition.
5. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is performed again by the same physician on the same day.
6. Modifier 77 - Repeat Procedure by Another Physician: This modifier indicates that the same procedure was performed again by a different physician on the same day.
7. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is used when a patient requires an unplanned return to the operating room for a related procedure within the global period.
8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is applicable when a different procedure is performed by the same physician during the postoperative period of the original procedure.
9. Modifier LT - Left Side: This modifier specifies that the procedure was performed on the left side of the body.
10. Modifier RT - Right Side: This modifier indicates that the procedure was performed on the right side of the body.
Using the appropriate modifiers ensures accurate billing and compliance with payer requirements, ultimately aiding in the efficiency of the revenue cycle management process.
The CPT code 27070 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and coverage criteria through the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for services covered by Medicare.
Additionally, it is crucial to consult with your local Medicare Administrative Contractor (MAC) to ensure compliance with any regional variations or specific documentation requirements that may affect reimbursement. Each MAC may have unique guidelines or policies that could influence the reimbursement process for CPT code 27070.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level and by individual payer. With RevFind, you can identify discrepancies for specific codes like 27070, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can streamline your revenue recovery process.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
